Effects of oral hygiene care on swallowing recovery in hospitalised patients with post-stroke dysphagia: a systematic review and meta-analysis
Sungkrit Pojmonpiti, Mariska Meersschaut, Katja Batens, Margot Baudelet, Veerle De Herdt, Barbara JanssensAbstract
Objective
To evaluate the effects of oral hygiene care on swallowing-related outcomes in hospitalised patients with post-stroke dysphagia (PSD).
Methods
A systematic literature search was conducted in MEDLINE, Embase, Web of Science, Scopus, CINAHL, CENTRAL and ClinicalTrials.gov up to May 2026. Randomised controlled trials (RCTs) and non-RCTs with a comparison group that reporting swallowing-related outcomes were included. Risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for non-RCTs. Where appropriate, meta-analyses were conducted using random-effects models to estimate mean differences (MDs), odds ratios (ORs) and risk differences (RDs) with 95% confidence intervals (CIs). The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.
Results
Nine studies, comprising 7 RCTs and two non-RCTs, were included, with risk-of-bias ratings ranging from low risk to some concerns for RCTs and moderate risk for non-RCTs. Oral hygiene care increased the odds of achieving independent oral intake compared with usual care (OR = 2.54, 95% CI, 1.80; 3.59; I2 = 0%), corresponding to a 13% absolute increase (RD = 0.13, 95% CI, 0.03; 0.23; I2 = 0%). Functional Oral Intake Scale (FOIS; scores 1–7), with higher scores indicating more independent and unrestricted oral intake, favoured oral hygiene care (MD = 0.40, 95% CI, 0.07; 0.72; I2 = 0%). Similarly, Gugging Swallowing Screen (GUSS; scores 0–20), assessing swallowing safety and dysphagia severity, favoured oral hygiene care (MD = 2.93, 95% CI, 1.01; 4.85; I2 = 0%). The certainty of the evidence for achieving independent oral intake was rated as high.
Conclusion
Oral hygiene care supports swallowing recovery in patients with PSD, particularly independent oral intake and should be considered an active component of dysphagia rehabilitation.